Grading of degenerative disk disease and functional impairment: imaging versus patho-anatomical findings

Eur Spine J. 2008 Dec;17(12):1705-13. doi: 10.1007/s00586-008-0787-6. Epub 2008 Oct 7.

Abstract

Degenerative instability affecting the functional spinal unit is discussed as a cause of symptoms. The value of imaging signs for assessing the resulting functional impairment is still unclear. To determine the relationship between slight degrees of degeneration and function, we performed a biomechanical study with 18 multisegmental (L2-S2) human lumbar cadaveric specimens. The multidirectional spinal deformation was measured during the continuous application of pure moments of flexion/extension, bilateral bending and rotation in a spine tester. The three flexibility parameters neutral zone, range of motion and neutral zone ratio were evaluated. Different grading systems were used: (1) antero-posterior and lateral radiographs (degenerative disk disease) (2) oblique radiographs (facet joint degeneration) (3) macroscopic and (4) microscopic evaluation. The most reliable correlation was between the grading of microscopic findings and the flexibility parameters; the imaging evaluation was not as informative.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomechanical Phenomena / physiology
  • Cadaver
  • Chondrocytes / pathology
  • Disability Evaluation
  • Disease Progression
  • Fibrocartilage / pathology
  • Fibrocartilage / physiopathology
  • Humans
  • Intervertebral Disc / diagnostic imaging
  • Intervertebral Disc / pathology
  • Intervertebral Disc / physiopathology
  • Intervertebral Disc Displacement / diagnostic imaging*
  • Intervertebral Disc Displacement / pathology
  • Intervertebral Disc Displacement / physiopathology*
  • Low Back Pain / diagnostic imaging
  • Low Back Pain / etiology
  • Low Back Pain / physiopathology
  • Lumbar Vertebrae / diagnostic imaging*
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / physiopathology*
  • Middle Aged
  • Movement / physiology
  • Predictive Value of Tests
  • Preoperative Care / methods
  • Radiography / methods*
  • Range of Motion, Articular / physiology*
  • Severity of Illness Index
  • Spinal Canal / diagnostic imaging
  • Spinal Canal / pathology
  • Spinal Canal / physiopathology
  • Spinal Stenosis / diagnostic imaging
  • Spinal Stenosis / pathology
  • Spinal Stenosis / physiopathology
  • Weight-Bearing / physiology